Cheese is the ultimate comfort food — so is ice cream, milk, and butter. Is there anything these ingredients don’t make better? Unfortunately for our taste buds, dairy products become harder for our bodies to digest as we age.
If you can’t drink coffee with heavy cream or eat something too cheesy without feeling sick, you may have lactose intolerance – even if you’ve never had that problem before.
Lactose is a natural sugar found in dairy products. According to the American College of Gastroenterology, our bodies depend on a digestive enzyme called lactase to help break down lactose into simple sugars (called glucose and galactose). The small intestine then absorbs it and it reaches the bloodstream as a nutrient.
If lactose is not digested properly, it moves to the large intestine and is broken down through fermentation. This causes uncomfortable symptoms such as stomach pain or cramps, excess gas, diarrhea and/or a sudden urge to defecate.
About 75% of the world’s population loses the ability to digest lactose as they age. We consulted experts to find out why this happens, plus some advice on how to handle it:
Why does lactose intolerance increase with age?
Drinking milk was important for our survival…at first.
“As babies, humans produce large amounts of lactase to digest the lactose found in breast milk,” said Linna Goelz, a doctor of naturopathic medicine at Sonoran University of Health Science. “Historically, once breastfeeding was completed and solid foods were introduced, humans no longer consumed foods containing lactose.”
And because humans don’t consume many foods that contain lactose, their bodies adapt and naturally begin to “produce less and less of the enzyme lactase as time goes by, which means we can’t digest dairy products as well,” according to Goelz.
This “gradual reduction” in lactase production is called lactase non-persistence or acquired lactase deficiency. Janese Laster, board-certified gastroenterologist and founder of Gut Theory Total Digestive Care, says this is “a natural process that occurs in most humans” after infancy.
You may notice these symptoms as a child, or they may appear in adulthood, depending on how slowly your body’s lactase production decreases. Or you could be part of the approximately 25% of humans who don’t notice any changes at all.
Your genes play a big role.
Ask your parents if they become more lactose intolerant as they get older, and that could give you a clue about your future. “The ability to digest lactose into adulthood depends on specific gene variants inherited from parents, which influence the level of lactase activity present,” Laster said.
She explains that your body’s ability to break down dairy products depends on the person. “While some people may have difficulty digesting fresh milk, they may find relief by consuming certain dairy products such as cheese or yogurt, thanks to the fermentation process that breaks down most of the lactose,” he continues.
Menka Gupta, a functional medicine physician at Nutra Nourish, notes that lactose intolerance is more common in people of Southeast Asian, East Asian, West African, Native American, and Hispanic descent “because they are more likely to carry gene mutations (APvegetOA2, MCM6) . However, it can happen to anyone.
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Your genetics can potentially predict whether you will struggle with lactose intolerance.
There are other reasons leading to increased lactose intolerance.
Of course, your gut is complicated, and there are definitely other reasons why dairy products don’t break down as well as they used to.
“External factors such as gastrointestinal diseases, accidents that cause injury to the small intestine, surgery that affects the small intestine, or conditions such as Crohn’s disease can contribute to the development of lactose intolerance,” explains Laster. “After gastrointestinal illness, there may be a temporary decrease in lactase stores in the body, thereby impacting lactose tolerance.”
Other things that can cause increased lactose intolerance include infections, inflammatory or autoimmune diseases such as gastroenteritis, celiac disease, Crohn’s disease, ulcerative colitis, chemotherapy and antibiotics, according to Gupta. This “causes injury to the intestinal mucosa, commonly known as leaky gut.”
You can treat the symptoms of lactose intolerance.
Although a natural decrease in lactase production cannot be reversed, there are several ways that can help overcome the symptoms of lactose intolerance.
Our experts recommend the following:
Narrow down which dairy products give you the worst symptoms and eliminate those symptoms. Foods such as hard cheese, butter and ghee may be easier to digest because they contain less lactose than milk or ice cream. Limit the amount of lactose consumed at each meal. Eat fermented milk products, such as probiotic yogurt or kefir, to help break down lactose. Avoid other known food sensitivities and allergens. For example, if your stomach is sensitive to hot sauce, eating it will decrease lactase production further and may worsen your symptoms. Switch to plant-based and non-dairy products when you can. Take probiotics, especially those containing Bifidobacterium, Saccharomyces, and Lactobacillus strains. Take a lactase supplement before consuming dairy products to help reduce symptoms.
Remember that nothing can truly “cure” lactose instability. “While changes in the microbiome may allow individuals to better tolerate various forms of fermented dairy products, it is unlikely that changes in gene expression would occur that would substantially increase lactase activity to levels observed in childhood,” Laster said.
You should always talk to your doctor before starting a new supplement or if you are concerned about increasing lactose intolerance. Gupta says “it’s important to find out the cause of your lactose intolerance,” which can be done through a variety of tests.
“Your doctor can recommend appropriate action by eliminating lactose from your diet or taking steps to improve your gut health,” he adds.